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A Himmelmann

Publications and source records attributed to A Himmelmann.

85 records · Page 5Linked to original sources
PubMed1988

Predictors of stroke in the elderly.

Hypertension, diabetes mellitus, coronary heart disease and cigarette smoking have repeatedly been identified as risk factors for stroke in young and middle-aged individuals. In order to find predicting factors for stroke in the elderly we assessed health characteristics in 55 stroke victims in the age range 65-75 years (mean 70.7 +/- 2.7) allocated to our stroke unit at Ostra University Hospital in Gothenburg. For comparison we used data from 2,009 individuals participating in the ongoing longitudinal population study "70-year-old people in Gothenburg, Sweden". Among the stroke victims we found a higher prevalence of hypertension (63.5% vs. 27.8%, p less than 0.001), diabetes mellitus (21.8% vs. 6.2%, p less than 0.001) and a history of previous myocardial infarction (12.7% vs. 4.8%, p less than 0.01), thus confirming previous findings. There was no difference with regard to smoking habits (32.7% vs. 27.5%, NS), which is at variance with findings in the young and middle-aged.

Age Factors↗
PubMed1985

The effect of postoperative external radiotherapy on cervical carcinoma stage IB and IIA.

Among 344 patients operated after intracavitary irradiation of cervical carcinoma stage IB and IIA, 55 had positive nodes in the operation specimen, 16 of these received no postoperative irradiation, 22 received pelvic irradiation without a boost dose to positive nodes, and 17 also received a boost. The crude 5-year survival was 52% for these 55 high-risk patients. All 3 patients with adenocarcinoma died. For squamous-cell carcinoma postoperative irradiation gave a later relapse and less distant metastases, but survival was not approved. Postoperative irradiation with a boost added, resulted in 3 recurrences among 16 patients, none in the treated volume, and only one complication. The numerically improved survival of this small group was not statistically significant, however. A randomized trial with and without postoperative irradiation with a boost dose, requiring 1100-1200 operated patients, would answer the question whether the observed improval is significant or not.

Adult↗
PubMed1985

Normal tissue reactions to high dose-rate intracavitary irradiation of the vagina with different fractionation schedules and dose levels.

The radiation reactions in the normal tissues of the vagina, rectum and bladder were studied in 166 patients receiving prophylactic vaginal high dose-rate intracavitary irradiation. Most reactions were observed in the vaginal mucosa included in the intracavitary target and only a few in the rectum and bladder in close proximity to the same target. The influence of the total dose, the dose per fraction and the overall treatment time, summarized as the Cumulative Radiation Effect (CRE), correlated well to the rate of reactions after a correction of the formula for late effects.

Brachytherapy↗
PubMed1983

High dose rate afterloading treatment in carcinoma of the uterine cervix using an individual planning and reconstruction system.

The results of intracavitary radiation treatment of 100 cases of cervical carcinoma stage I B and II A with a high dose rate afterloading system are reported. To increase treatment precision an individual method was used with definition of the target and with a detailed three-dimensional computer planning system. A Wertheim operation followed intracavitary treatment and postoperative external irradiation was only given to cases with positive nodes. Residual tumor was found to the same extent as with the former manual radium treatment. Besides having achieved full radiation protection of the staff, radiation reactions among patients were almost eliminated.

Adenocarcinoma↗
PubMed1983

Computed tomography measurements of the cervix and distances to the bladder and rectum in intracavitary radiation treatment of gynaecological cancer.

Improved knowledge of the topography of target and adjacent organs in intracavitary irradiation of gynaecological tumours is needed when a high dose rate afterloading system with good precision is used. To get this information, 16 patients with small carcinomas were examined by computed tomography scan with applicators inserted. The thickness of the vesico and rectovaginal septa was measured. In the ten cervical carcinomas the minimum thickness was 4 mm. In the six early corpus carcinomas the vesicovaginal septum thickness was 7 to 9 mm while the rectovaginal septum thickness was 5 to 7 mm. Measurement of the cervical diameter seems to be valuable and can give information about suitable intracavitary target dimensions. In this way overtreatment of the bladder and rectum can be avoided and a more precise dose can be delivered to the entire target volume.

Brachytherapy↗
PubMedDate not supplied

Intracavitary irradiation of carcinoma of the cervix stage IB and IIA. A clinical comparison between a remote high dose-rate afterloading system and a low dose-rate manual system.

The clinical results of a remote high dose-rate afterloading technique with individual three-dimensional treatment planning were compared with those of a manual low dose-rate technique for intracavitary irradiation of cervical carcinoma stage IB and IIA. The rates of residual tumour at operation, local recurrence and survival were comparable with the two techniques. The rate of treatment complications was lower with the high dose-rate technique even when external irradiation was added. Better central shielding for external pelvic irradiation is possible when intracavitary irradiation is performed with higher accuracy.

Adenocarcinoma↗
PubMedDate not supplied

Cytotoxic effects of hexadecylphosphocholine in neoplastic cell lines including drug-resistant sublines in vitro.

Hexadecylphosphocholine (HPC) was tested in comparison with the membrane-toxic reference ether lipid ET-18-OCH3 for cytotoxic (trypan blue dye exclusion) and cytostatic/antiproliferative [( 3H]thymidine uptake) activity in six cell lines of human hematologic malignancies, six cell lines of human solid tumors and four drug-resistant sublines and their respective non-resistant parent lines in vitro. HPC showed time- and dose-dependent antiproliferative and cytotoxic activity in almost all cell lines, including drug-resistant sublines over a dose range of 2-120 microM and after incubation times of 24, 48 and 72 h. However, ET-18-OCH3 showed a significantly higher activity than HPC, when both compounds were compared on an equimolar basis. The human tumor clonogenic assay confirmed these results. Furthermore, no cross-resistance for HPC with colchicine or methotrexate and partial cross-resistance for HPC with adriamycin was found in cell lines selected for drug resistance. In conclusion, HPC is cytotoxic for neoplastic cells of different histologies including drug-resistant sublines in vitro. Although its cytotoxicity starts at somewhat higher doses when compared to ET-18-OCH3, further testing as an experimental anticancer drug in vivo and comparative cytotoxicity studies with hematopoietic progenitor cells from bone marrow are recommended.

Antineoplastic Agents↗
PubMedDate not supplied

Antiestrogenic treatment of advanced and recurrent carcinoma corporis uteri--a phase II study of toremifene.

The antitumor efficacy and toxicity of a new anti-estrogenic substance--toremifene--were investigated in a phase II study. Twenty-six patients were eligible for final evaluation (6 primary and 20 recurrent disease). A daily dose of 200 mg toremifene was given orally. Treatment continued for at least 3 months, until progression or significant side-effects were encountered. The response rate was 35% (3 CR and 6 PR). Six patients had NC and 11 did not respond to the treatment. The median duration of responses for CR was 10+ months (range 3(+)-19) and for PR 4 months (range 3(+)-16). The treatment seems to be well tolerated and effective.

Aged↗
PubMedDate not supplied

Prospective malignancy grading, flow cytometry DNA-measurements and adjuvant chemotherapy for invasive squamous cell carcinoma of the uterine cervix.

In a prospective study comprising 310 consecutive patients with carcinoma of the cervix, FIGO stages I-IV, the prognostic significance of clinical and flow cytometric variable was evaluated in a univariate and multivariate analysis. The parameters studied included stage according to FIGO, age, histopathologic grade according to Ackerman and MGS scores, DNA ploidy, S-phase fraction as well as treatment with radiation only, surgery only or a combination thereof as well as adjuvant chemotherapy. Univariate analysis showed that patients in FIGO stages IA-IIA with MGS up to 14 points survived significantly better than other groups. MGS parameter mitosis, vascular invasion and type of invasion predicted survival as did clinical stage. Diploid cases with SPF > 15% survived less than remaining other cases. Multivariate analysis not including treatment indicated that FIGO stage and diploid cases with SPF > 15% predicted survival but not total MGS score and age. When treatment for FIGO stages IA-IIA was included, elderly women had a worse prognosis. Adjuvant chemotherapy, surgical alone or radiation alone did not demonstrate any differences within groups. In Figo stages IIB-IV, cases with radiotherapy only survived significantly better than patients with other treatment schedules. The frequency of low malignancy patients (< MGS 16) in relation to year of initial diagnosis was found to have decreased between years 1967 and 1988, probably as a result of screening activities.

Adult↗